Intra-Amniotic Sludge, Short Cervix, and Risk of Preterm Delivery

Bujold, Emmanuel; Pasquier, Jean-Charles; Simoneau, Jessica; Arpin, M. H.; Duperron, Louise; Morency, Anne‐Maude; Audibert, François

doi:10.1016/s1701-2163(16)32108-9

Cited by 58 publications

(35 citation statements)

References 9 publications

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“…We found no significant differences in the association between amniotic fluid sludge and histological chorioamnionitis as it was described previously [8,20,23] . Not all placentas underwent histological examination and this is an important limitation of our study.…”

Section: Discussionsupporting

confidence: 71%

“…Thus, the shorter the cervical length, the greater the likelihood of amniotic sludge. However, after adjusting for cervical length ^ 15 mm, amniotic sludge remained an independent risk factor related to impending preterm delivery, as it was described previously [8,20,23] .…”

Section: Discussionsupporting

confidence: 69%

“…These results are similar to those described by Espinoza et al [8] in women in preterm labor with intact membranes in which amniotic sludge was not an independent risk factor for preterm delivery before 32 and 35 weeks. Amniotic sludge has been reported as an independent risk factor for preterm delivery before 28, 32 and 35 weeks [23] and also before 34 weeks [20] in high-risk patients but not in preterm labor. These differences can be explained by the high prevalence of a short cervix in patients in preterm labor and the higher gestational age of the patients we included in our cohort [20,23] .…”

Section: Discussionmentioning

confidence: 99%

“…In the third trimester of pregnancy, free-floating particulate matter has been attributed to the presence of vernix and meconium [15][16][17][18] and is present in about 88% by 35 weeks [19] . However, the sonographic appearance of what has been termed 'intra-amniotic fluid sludge' seen at cervical ultrasound is different [8,20,21] . Amniotic fluid sludge appears as a free-floating hyperechogenic material within the amniotic fluid and always in close proximity to the internal os or within the cervical funneling when the latter Fig.…”

Section: Discussionmentioning

confidence: 99%

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Risk of Impending Preterm Delivery Associated with the Presence of Amniotic Fluid Sludge in Women in Preterm Labor with Intact Membranes

et al. 2011

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Objective: To determine the association of amniotic fluid sludge with impending preterm delivery in women in preterm labor with intact membranes. Methods: This was a retrospective cohort study in women at 22–34 weeks’ gestation in preterm labor with intact fetal membranes between February 2008 and May 2009. 16 women with amniotic sludge were identified. Each case of amniotic sludge was matched with 3 randomly selected controls. The primary outcome was delivery within 48 h of examination. Results: Mean cervical length was shorter in women with sludge than women without sludge (20.5 ± 9.0 vs. 27.9 ± 6.9 mm, p = 0.0016). There was a significant difference in the mean ultrasound-to-delivery interval in women with and without sludge (21.7 vs. 49.4 days, p = 0.006). Logistic regression analyses demonstrated that amniotic fluid sludge is a strong independent predictor of impending preterm delivery within 48 h (OR 11.2, 95% CI 1.2–125.9), 7 days (OR 3.8, 95% CI 1.2–17.3) and 14 days (OR 7.5, 95% CI 1.8–30.4). Conclusions: Amniotic fluid sludge on ultrasound scan is associated with impending preterm delivery in women in preterm labor with intact membranes.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Risk of Impending Preterm Delivery Associated with the Presence of Amniotic Fluid Sludge in Women in Preterm Labor with Intact Membranes

et al. 2011

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“…The debris may represent inflammatory material and, as such, has been associated with an increased risk of preterm birth. 26,27 As a side note, TVUS can be useful for more than just CL measurements. Diagnoses such as placenta previa and vasa previa can be made only using this The T-Y-V-U schematic representation describing the shape of the interface between the internal cervical os and the lower uterine segment.…”

Section: The Techniquementioning

confidence: 99%

Measuring the Cervical Length

Markham

Iams²

2016

Clinical Obstetrics &Amp; Gynecology

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An important step toward the goal of eradicating spontaneous preterm birth was achieved with the advent of cervical sonography, a tool that advanced our knowledge of the entity of preterm parturition, improved our ability to detect women at risk for early delivery, and allowed us to prevent some of these premature births. We will describe here the correct technique for obtaining such measurements and will review the literature regarding the use of this tool in specific pregnant populations.

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Antibiotic treatment of amniotic fluid “sludge” in patients during the second or third trimester with uterine contraction

Jin

Kim

et al. 2020

Intl J Gynecology & Obste

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Objective To assess the effectiveness of antibiotic treatment in patients with amniotic fluid (AF) “sludge” during the second or third trimester with uterine contractions and intact membranes. Methods A retrospective cohort study was conducted of women at 15–32 weeks of pregnancy with uterine contractions and intact membranes. Women with AF “sludge” were treated with an antibiotic regimen of ceftriaxone, clarithromycin, and metronidazole. Based on changes in AF “sludge,” patients were divided into group A (disappearance of “sludge”) and group B (persistent “sludge”). Results Women in group A (n=30) delivered later than those in group B (n=28). Group A showed a smaller initial size of “sludge” than group B (all P<0.05). Women in group A had a lower rate of preterm birth within 7 days, and before 28, 32, and 34 weeks of pregnancy, and composite neonatal morbidity and perinatal death than group B (all P<0.05). Conclusion The administration of antibiotics may eradicate AF “sludge” in women in the second or third trimester with uterine contractions and intact membranes, which are associated with the initial size of “sludge.” Patients with disappearing “sludge” had more favorable pregnancy and neonatal outcomes than those with persistent “sludge.”

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Intra-Amniotic Sludge, Short Cervix, and Risk of Preterm Delivery

Cited by 58 publications

References 9 publications

Risk of Impending Preterm Delivery Associated with the Presence of Amniotic Fluid Sludge in Women in Preterm Labor with Intact Membranes

Risk of Impending Preterm Delivery Associated with the Presence of Amniotic Fluid Sludge in Women in Preterm Labor with Intact Membranes

Measuring the Cervical Length

Antibiotic treatment of amniotic fluid “sludge” in patients during the second or third trimester with uterine contraction

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